Fatal Acute Pancreatitis Occurring Outside of the Hospital: Clinical and Social Characteristics
Fatal Acute Pancreatitis Occurring Outside of the Hospital: Clinical and Social Characteristics
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DOI：
10.1007/s00268-010-0693-z
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发表时间：
2010-10-01
影响因子：
2.6
通讯作者：
Andersson, Roland
中科院分区：
文献类型：
--
作者：
Andersson, Bodil;Ansari, Daniel;Andersson, Roland
背景：入院患者因急性胰腺炎引起的死亡率已被彻底调查，但关于门诊死亡的知识还远远不够完整。本研究的目的是评估因院外发生的急性胰腺炎而死亡的患者的发病率和临床特征。方法对1994-2008年瑞典南部地区因急性胰腺炎死亡的病例在隆德法医学部门进行鉴定。对所有病例进行回顾性审查。结果共纳入50例患者，占该地区在此期间因急性胰腺炎死亡的292例患者中的约50例（17%）。中位年龄为54岁（47-69岁），男性占多数（74%）。主要病因为酒精，至少有35例（70%）患者出现。12例（24%）患者为肥胖。在可评估的病例中，腹痛持续时间为3.0（1.6-6.2）天。所有患者均有严重的胰腺炎征象；组织病理学检查有坏死性疾病35例（70%）。肺部病变很常见，如支气管肺炎、胸腔积液或水肿，除4例外均有脂肪肝。1例患者腹部大量出血。至少有8名患者患有精神障碍，3名患者无家可归。结论院内外发生的致死性急性胰腺炎占该疾病死亡的很大一部分。发病率似乎有所下降，且未见季节变化。酒精是主要病因。许多病人独居，社会条件恶劣。
Background Mortality caused by acute pancreatitis in patients admitted to the hospital has been thoroughly investigated, but knowledge regarding outpatient fatalities is far from complete. The purpose of this study was to assess the incidence and clinical characteristics of patients who have died due to acute pancreatitis occurring outside the hospital.Methods Deaths caused by acute pancreatitis in the southern part of Sweden during 1994-2008 were identified at the Department of Forensic Medicine, Lund. A retrospective review of all cases was performed.Results A total of 50 patients were included, representing approximately 50 of 292 (17%) of all deaths due to acute pancreatitis in the region during this period of time. Median age was 54 (47-69) years and the majority-37 (74%) were men. The main etiology was alcohol, seen in at least 35 (70%) patients. Twelve (24%) patients were obese. The duration of abdominal pain, in evaluable cases, was 3.0 (1.6-6.2) days. Profound signs of pancreatitis were seen in all patients; 35 (70%) had a necrotising disease according to histopathological examination. Pulmonary changes were common, e.g., bronchopneumonia, pleural effusion, or edema, and all but four had fatty liver. Massive intra-abdominal bleeding was seen in one patient. At least eight patients had a mental disorder, and three were homeless.Conclusions Fatal acute pancreatitis occurring outside the hospital accounts for a substantial part of all deaths due to the disease. The incidence seems to decline, and no variation in season was seen. Alcohol was the predominant etiology. Many of the patients lived alone and in poor social conditions.